Bursitis

Question 0

Bursitis

Answer 0

Inflammation of bursa walls caused by overuse of surrounding structures.

Can also be caused by trauma, infection,OA, gout, RA

Question 1

Bursa

Answer 1

Small, flat, synovium-lined sac that acts to reduce friction.

Question 2

Subacromial bursa

Answer 2

Between Acromion and supraspinatus tendon

Palpated through anterior deltoid

Bursitis usually part of impingement syndrome. (Compressed between rotator cuff tendons, coracoacromial ligament and acromion)

Question 3

Subscapular bursa

Answer 3

Between scapula and subscapularis

Not easily palpated

Question 4

Olecranon bursa

Answer 4

Between Olecranon and subcutaneous fascia.

Irritated by weight bearing or trauma.

Palpable when inflamed

Question 5

Trochanteric bursa

Answer 5

Two:
Between glute max tendon and trochanter, and between glute min tendon and trochanter.

Pain on lateral hip.
Difficulty sleeping on affected side; pain with stairs and getting in/out of car

Question 6

Iliopectineal bursa

Answer 6

Between iliopsoas and iliofemoral ligament

Palpate: supine. Hip flexed to 90°. Bursa 1-2 cm inferior to middle of inguinal ligament

Pain at anterior hip and possibly anterior leg (pressure on femoral nerve)

Question 7

Ischial bursa

Answer 7

Between glute Max and Ischial tuberosity

Palpate through glute max.

“Bench warmers bursitis”. Pain at Ischial tuberosity. Possible pain down posterior leg. Pain relieved when pushing of gas/brake pedals.

Question 8

Pes Anserine bursa

Answer 8

Between tendons of Sartorius, gracious and semitendinosus, and medial tibia.

Question 9

Infrapatellar bursa

Answer 9

Between patellar ligament and tibia

Question 10

Prepatellar bursa

Answer 10

Between inferior patella, patellar ligament, and skin.

Question 11

Retrocalcaneal ligament

Answer 11

Between Achilles’ tendon and calcaneus.

Palpate either side of tendon.

Overuse, tight calves.

Question 12

Bakers cyst

Answer 12

Synovial Cyst in lateral popliteal space.

Disappears after a couple of years

Question 13

Bunion

Answer 13

At MTP 1

Callus, thickened bursa, valgus toe.

Question 14

Acute bursitis

Answer 14

Inflammation.
Deep, burning pain at rest or activity

May refer.

Decreased ROM across joint.

Possible comorbidity with Tendonitis.

Question 15

Bursitis: chronic

Answer 15

Pain with activity, direct pressure. More localized at bursa.
Chronic inflammation, bursitis, adhesions.
ROM less affected than acute
May be boggy

Question 16

Bursitis: CI’s

Answer 16

In acute: don’t compress or drag!

Question 17

Acute bursitis: Tx

Answer 17

Cold
MLD
Swedish to compensating structures
TrP: muscle stripping, ischemic compressions  (proximal) 
GTO release 
Petrissage toward bursa.
Gentle joint play

Question 18

Chronic bursitis: Tx

Answer 18

Heat before, contrast during
MFR on crossing muscles. 
Swedish to compensating structures. 
TrP
C-scoop toward bursa 
Frictions
Joint play.

Question 19

Bursitis/Tendonitis differentiation test

Answer 19

Isometric test
Bursitis: constant pain
Tendonitis: pain with increasing resistance